Psoriasis

For most kids, psoriasis is limited to just a few
patches that usually respond well to treatment. More serious cases might need more
aggressive treatment. But the good news is that there are many options. If one treatment
doesn't work, another probably will.

What Is Psoriasis?

Psoriasis (suh-RYE-uh-sus) is a non-contagious disease that causes skin cells to
build up on the surface of the skin, forming itchy red raised areas (plaques)
and thick scales. It can appear anywhere on the body but is most commonly found on
the scalp, knees, elbows, and torso.

Psoriasis is a long-lasting (chronic) condition that can get better or worse, seemingly
at random. It may go away completely before suddenly reappearing.

For many kids, psoriasis is just a minor inconvenience; for others, though, it
can be quite serious. Psoriasis can lead kids to feel self-conscious about their appearance.
Sometimes that affects their emotions, and some kids may develop low self-esteem and
even depression as a result.

Right now, there's no cure for psoriasis, but a number of good options are available
to treat the symptoms. Lifestyle changes, such as maintaining a healthy diet and weight,
also can help ease the symptoms.

What Causes Psoriasis?

Doctors aren't sure why people get psoriasis, but they do know how the disease
works. White blood cells known as T lymphocytes or T cells are part of the immune
system. They travel through the bloodstream fighting off bacteria, viruses, and
other things that cause illnesses. When someone has psoriasis, however, T cells attack
healthy skin as if they were trying to fight an infection or heal a wound.

Skin cells, which are made deep in the skin, normally take about a month to rise
to the surface, where they die and are sloughed off. When psoriasis triggers T cells
to attack healthy skin, the immune system responds by sending more blood to the area
and making more skin cells and more white blood cells. This forces skin cells to rise
to the surface in a few days instead of a month. The dead skin and white blood cells
can't be shed quickly enough, and they build up on the surface of the skin as thick,
red patches. As the skin cells die, they form silvery scales that eventually flake
off.

Psoriasis isn't contagious. Some people inherit the genes that make them susceptible
to having it. Many with psoriasis have an immediate family member who also has
the disease.

Risk factors that can increase the chances of psoriasis outbreaks include:

Infections.Strep
throat, colds, and other infectious diseases trigger the body's immune system
to respond, making a psoriasis outbreak more likely.

Obesity.
The plaques that are produced by many kinds of psoriasis often develop in folds of
skin.

Certain medicines. Lithium, beta-blockers for high
blood pressure, and drugs used to prevent malaria
have been shown to increase the risk of psoriasis.

Stress. High stress
levels can have an effect on the body's immune system and can make psoriasis symptoms
worse.

Skin irritations. Cuts, scratches, sunburns,
rashes, and other irritations that affect the skin can make a psoriasis outbreak more
likely.

Cold weather. In the winter, kids generally spend more time indoors
and get less sun. A moderate amount of direct sunlight can help to improve psoriasis.

What Are the Signs and Symptoms of Psoriasis?

People with psoriasis will most likely have one or more of these symptoms:

raised red patches of skin that can have silvery scales on them

dry, cracked skin that may bleed at times

itching, soreness, or a burning sensation in the affected area

thick, pitted fingernails

There are many different types of psoriasis that all have their own symptoms. Common
types include:

Plaque psoriasis. By far the most common type of psoriasis, this
causes dry red patches (plaques) and silvery scales. Plaques can appear anywhere on
the skin but most often are on the knees, elbows, lower back, and scalp. They can
be itchy and painful and may crack and bleed.

Guttate psoriasis. This most often affects people younger than
30 and often shows up after an illness, especially strep throat. It causes small red
spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp,
and ears or where someone had plaque psoriasis.

Pustular psoriasis. This type of psoriasis causes the skin to
become red, swollen, and covered with pus-filled bumps. Usually, this is on the soles
of the feet or the palms and fingertips. Sometimes, though, it covers large areas
of the body. This is known as generalized pustular psoriasis, and can sometimes be
accompanied by fever, chills, severe itching, and fatigue.

Inverse psoriasis. This causes smooth, raw-looking patches of
red skin that feel sore. The patches develop in places where skin is touching skin,
such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman's
breasts.

Erythrodermic psoriasis. This type of psoriasis is rare. It can
cause a bright red rash that covers the entire body, making the skin look as if it
has been burned. It's often accompanied by intense itching and pain, a fast heartbeat,
and an inability to maintain a proper body temperature.

How Is Psoriasis Diagnosed?

Usually, diagnosis of psoriasis is fairly straightforward. The doctor will physically
examine your child's skin, scalp, and nails and ask you and your child some questions.
The doctor may ask if anyone in your family has psoriasis and if your child recently
had an illness or started a new medication.

On rare occasions, the doctor may remove a skin sample (do a biopsy) to examine
it more closely. A biopsy can tell the doctor whether it's psoriasis or another condition
with similar symptoms.

How Is Psoriasis Treated?

There are lots of ways to treat psoriasis, and different things work for different
people. Be sure to talk with a doctor to figure out what treatments work best for
your child.

Psoriasis treatments fall into three categories:

Topical treatments are creams, lotions, and ointments applied
directly to the skin. These include moisturizers, prescription corticosteroids and
vitamin D creams, and shampoos made with salicylic acid or coal tar. Topical treatments
can effectively treat many types of mild to moderate psoriasis, but can be a little
messy.

Light therapy(phototherapy) involves using
natural or artificial ultraviolet (UV) light to treat the psoriasis symptoms. A doctor
may recommend brief daily exposure to the sun, but too much sunlight can make psoriasis
worse. More aggressive forms of light therapy include using controlled doses of UV
light on the affected skin, laser therapy, and therapies that combine UV light with
medicines and topical treatments.

Oral or injected medications are used to treat severe psoriasis
or psoriasis that resists other treatments. They include pills, shots, and medicines
given intravenously (through an IV into a vein). Some of these can have serious side
effects and might be prescribed for short periods of time only.

A doctor might try one therapy and then switch to another, or recommend a combination
of therapies. It's not always easy to find a therapy that works, and sometimes what
works for a time will stop being effective. It's important to work closely with the
doctor to stay on top of your child's treatment.

Things You Can Do at Home

Besides following your doctor's advice, you can help your child by making healthy
lifestyle choices:

Serve healthy foods. Eating a lot of fruits and vegetables can help fend off diseases
that might trigger psoriasis.

Help your child stay at a healthy weight. This decreases the risk of inverse psoriasis.

Remind your child to keep skin clean and well moisturized. Bathing daily with
bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.

Spend time outdoors. Limited amounts of natural light can help with psoriasis.

Give your child emotional support. Many kids who have emotional problems due to
their psoriasis can benefit from talking with a therapist or joining a support group
of people who understand the challenges of dealing with psoriasis.

Most psoriasis will respond well to treatment, but it's important to stay on top
of it. If your child should apply an ointment twice a day, remind him or her to do
so; if a little more sun is recommended, join your child for a daily walk. Your efforts,
and your child's, will help control psoriasis symptoms.